Individual
DR. IYLA TIKHONOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4094
Mailing address
3378 WOODBURN RD APT T3, ANNANDALE, VA 22003-6817
(703) 470-5588
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
06-228
VA
Other
Enumeration date
07/16/2009
Last updated
07/21/2009
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